Predictors of Plasmodium vivax malaria-induced nephropathy in young Korean men.
BACKGROUND
Plasmodium vivax malaria accounts for more than half of all malaria cases in Asia and Latin America. Despite the high prevalence of disease caused by this parasite, research into its effects (especially its renal effect) has lagged disproportionately. To investigate predictors of vivax malaria-induced nephropathy, we analyzed the cases of vivax malaria-induced nephropathy in young Korean men.


METHODS
This was a retrospective analysis of P. vivax patients with acute nephropathy (all males, n = 75), defined by an absolute increase in serum creatinine of 0.3 mg/dl or more (equal to an estimated glomerular filtration rate (eGFR) <80 ml/min) (group 1, n = 31) or proteinuria (group 2, n = 44), between January 2004 and December 2007. The eGFR was calculated using a simplified Modification of Renal Disease (MDRD) equation. None of the patients had a history of traveling abroad, drug abuse or blood transfusion. The clinical manifestations, laboratory abnormalities and predictors of nephropathy were reviewed.


RESULTS
Out of 398 cases of vivax malaria, 75 patients (all males) suffered from to vivax malaria-induced acute nephropathy. The mean age of the patients who were divided into two groups was 22.8 +/- 3.7 and 21.6 +/- 1.8 years, respectively (p = 0.089). In group 1, the total serum bilirubin significantly correlated with serum creatinine and eGFR (p = 0.004 and 0.035, correlation coefficient = 0.508 and -0.387, respectively). In group 2, 24-hour proteinuria significantly correlated with hemoglobin (p = 0.004, correlation coefficient = -0.424).


CONCLUSIONS
Total serum bilirubin (group 1, an absolute increase in serum creatinine of 0.3 mg/dl or more (equal to an eGFR <80 ml/min)) and hemoglobin (group 2, proteinuria) are useful to predict vivax-induced nephropathy.
Chung
Byung Ha
BH
Department of Internal Medicine, The Armed Forces Yangju Hospital, Yangju City, Gyeonggi Province, Republic of Korea.
Lee
Sei Won
SW
Lee
Sang Eun
SE
Hwang
Tae Jun
TJ
Shin
Ho Sik
HS
D015984:Causality; D015897:Comorbidity; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D016780:Malaria, Vivax / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D011379:Prognosis; D051437:Renal Insufficiency / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult